Teen's suicide tied to concussion

Wednesday

Aug 31, 2011 at 2:00 AM

NOKESVILLE, Va. – Austin Trenum's bed remains half-made, the way a typical teenager would leave it. On a shelf is his scarred black helmet, the one he was wearing when he tackled the quarterback near the sidelines during Brentsville High's game against Handley some 11 months ago.

JOSEPH WHITE

NOKESVILLE, Va. – Austin Trenum's bed remains half-made, the way a typical teenager would leave it. On a shelf is his scarred black helmet, the one he was wearing when he tackled the quarterback near the sidelines during Brentsville High's game against Handley some 11 months ago.

Austin's mouthpiece remains tucked neatly in the face mask, ready to be taken out for the next play.

For Austin, there was no next play.

Downstairs in the Trenum home, in the living room to the left of the television, is a memorial in photographs to the 17-year-old college-bound senior who wore No. 43 in football, No. 14 in lacrosse, all sorts of crazy hats when he felt like it, a “fro-hawk” of curly hair, and a pair of women's sunglasses on a lark one day while riding back from the beach.

Austin's final play left him with a concussion. Two days later, with the rest of the family downstairs in the house, he went up to his room and hanged himself.

To the grieving parents, there is no doubt that one caused the other. Shortly after his death, Gil and Michelle Trenum made the difficult decision to donate Austin's brain for research.

Seated around their dining table, they told their son's story, hoping his death can leave a legacy for others of lessons learned – that concussions still aren't taken as seriously as they should be; that athletes, parents, coaches, trainers and even emergency room workers are often ill-informed as to how to treat them; that more of a culture change is needed in a sport in which blows to the head are considered badges of honor.

“I grew up in a football culture,” Michelle Trenum said. “I'm from Texas, and my father went to college on a football scholarship, and we have three boys that were all playing football. We referred to ‘getting your bell rung,' ‘getting the snot knocked out of you,' those types of things. I never realized they were traumatic brain injuries. I thought as long as you were getting up, you were OK.”

“If our son did not have a concussion, he would be here right now,” she added, fighting back tears. “Actually, he wouldn't be here, he would be in a dorm room.”

Concussion awareness in sports is on the rise. The NFL has done an about-face in recent seasons, instituting return-to-play rules and other strict guidelines after years of being accused of not taking the issue seriously. Hearings have been held on Capitol Hill.

Only four months before Austin's death, the football world was stunned by the suicide of University of Pennsylvania co-captain Owen Thomas, who was found to have a brain disease that could have been caused by repeated blows to the head.

But the full trove of medical knowledge has yet to filter down to the high school level, and it wasn't there on the night Austin was injured. His parents took their groggy son to the emergency room – Friday night is already one of the worst times to go to the hospital – and were told to watch for bleeding symptoms and to make sure their son had 24 hours of restful activity.

So he watched game film the next day. He went fishing with a friend in the afternoon. He went to a concert with his girlfriend that evening. He texted. He played video games. On Sunday, he was doing homework. He planned to go to his girlfriend's house later to watch the Redskins game. All of which seemed suitably restful.

But he also missed a routine turn while driving a car near the home. He couldn't remember something obvious while talking to his friend while fishing. He woke up early Sunday and went downstairs to play video games, something totally out of character for him. He had also mentioned that he had been getting a "football headache" after every game, something he hadn't told his parents before.

They did know that Austin, who played linebacker and fullback, had at least one concussion the previous season, and probably two others that fit symptoms he had described.

For seemingly no reason at all, Austin went upstairs Sunday afternoon and never returned. Afterward, it wasn't hard to connect the dots. He had no history of depression. Nor does his family. He was well-liked at school. He was in the top 6 percent of his class and a shoo-in for James Madison University. He was making plans. All the soul-searching for answers led to only one.

“It was literally out of the blue,” Michelle Trenum said. “There was nothing in his life, in his character, in his emotions that would have ever – we know it was a concussion.”

The Trenums received a call from Boston University's Center for the Study of Traumatic Encephalopathy, where there is a bank of about 70 brains that have been donated for study, many from athletes and military veterans. It offered a chance for some answers.

“It was somebody who thought we had a valid point,” Michelle Trenum said. “I worried about my baby. It was very hard. He was an organ donor as well, and that was hard. But I thought I really want to know.”

The CSTE found that Austin had a multifocal axonal injury – structural damage to the brain. Among the areas affected was the portion of the brain that affects judgment and impulse control. The doctors can't say for sure why Austin killed himself, but there is strong circumstantial evidence.

“We know that a concussion can be followed with depression,” said Dr. Robert Cantu, clinical professor of neurosurgery and co-director of the center. “And depression can be serious enough that hospitalization is required in a small number of cases. We also know that in his brain there were structural abnormalities – and (we are) clearly very concerned that there was cause and effect because of that. Do I know it with 100 percent certainty? No. Can I put what percent certainty I know it at? No. Do I think it's more likely that not? Yes.”

The Trenums had their answer. Now they want to share it with others.

“It was scientific validation for what we knew,” Michelle Trenum said. “But it was an agonizing gift to be given that information because you realize there's other parents out there that have unanswered questions and they've lost loved ones, too. It's what you do with that.

"That's why, with Austin, we would like his legacy to be that other people were helped, that other parents don't have to go through this, that other teammates realize when a teammate has a traumatic brain injury, they realize it and bring it to the attention of the coach.”

The Trenums also learned how their son's concussion should have been treated. Someone with symptoms as serious as Austin's should have rest with virtually no brain stimulation at all. No watching game film. No fishing. No concerts. No video games. No texting. No television. It should be that way for as long as the symptoms last, even if it means days of inactivity.

“If it was my son again,” Gil Trenum said, “if he got another concussion, he would be just lying down on the couch.”

Gil Trenum is a member of the Prince William County School Board. He is wearing two plastic bracelets, orange from Austin's senior class and yellow from the lacrosse team, in his son's memory. He worked to get new guidelines implemented for all athletes at the county's schools. New return-to-play criteria. Concussion training for trainers. A seminar that includes an eye-opening video, with attendance mandatory for students and their parents as a prerequisite for participating in any sport, not just football.

“I do want Prince William County to lead the way on that,” Gil Trenum said. “I think we can set the standard.”

And, along with that standard, would come the hoped-for culture change. The Trenums haven't disavowed football – their youngest son still plays the sport – but they say it's time for athletes, parents and coaches everywhere to realize that a concussion is a brain injury that needs serious, informed treatment.

Before it becomes a life-or-death issue.

“Car seats are a good example,” Gil Trenum said. “When I was a baby and came home from the hospital, my mom rode in the front seat of the car, holding me in her arms, no seat belt. That was the way things were done then. Now we've got technology changes. We've got procedural changes. We've got cultural changes. People would be shocked if you did that now.”

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